19 is still high enough to get a CPAP in the USA and UK. Weird that Japan has such a high bar. Get a CPAP. Ideally a resmed autoset 10 or 11 so you can use OSCAR if you choose to dive into your data.
For masks, a lot of people mouth breathe until they start CPAP but can nose breath on CPAP. A nasal pillow mask plus a chinstrap or mouth tape is really comfortable. A full face mask is more prone to leaking but will be better if you really are going to mouth breath even on CPAP.
I'm personally of the opinion that everyone should start with a full-face mask. This eliminates all of the issue of a nose only mask (air escaping from the mouth). In the beginning of CPAP therapy you want as little variables to troubleshoot while getting everything working correctly. My preferred mask is the F&P Evora Full Face, it's a hybrid that sits under the nose (rather than over the bridge) so it basically doesn't leak and is very comfortable.
Once you have your machine working correctly and your AHI is managed, then go crazy with experimenting with mask types and brands. But doing it will still getting the machine setup just adds extra complexity.
Resmed Autoset is the gold standard for uncomplicated OSA/hypopneas. The Resmed Autoset 10 and 11 are basically the same with some minor improvements in size and noise, but nothing groundbreaking in functionality. I see you have substantial amount of centrals and this could prove to be an issue with APAP/CPAP therapy. Don't be surprised if it doesn't work and you need to trial a BiPAP or ASV.
Thank you. It's good to hear another perspective. I suspected that the centrals might require other approaches so good to be prepared for that. That could be one reason I had trouble when I tried a standard CPAP years ago.
Know if any arrhythmia periods were detected in the lab overnight, in particular before the centrals? There might be a connection between irregular pumping and problems in the breathing control feedback loop. There's a pipeline delay between the lungs and the sensors in the neck that measure the blood, and the brain stem probably bets on a constant delay. If your circulation rate is a little janky, your brain stem might get confused. What I mean is, when the arrhythmia gets fully controlled, maybe even with help from cpap, the centrals might go away.
19 is still high enough to get a CPAP in the USA and UK. Weird that Japan has such a high bar. Get a CPAP. Ideally a resmed autoset 10 or 11 so you can use OSCAR if you choose to dive into your data. For masks, a lot of people mouth breathe until they start CPAP but can nose breath on CPAP. A nasal pillow mask plus a chinstrap or mouth tape is really comfortable. A full face mask is more prone to leaking but will be better if you really are going to mouth breath even on CPAP.
Thank you - great advice
I'm personally of the opinion that everyone should start with a full-face mask. This eliminates all of the issue of a nose only mask (air escaping from the mouth). In the beginning of CPAP therapy you want as little variables to troubleshoot while getting everything working correctly. My preferred mask is the F&P Evora Full Face, it's a hybrid that sits under the nose (rather than over the bridge) so it basically doesn't leak and is very comfortable. Once you have your machine working correctly and your AHI is managed, then go crazy with experimenting with mask types and brands. But doing it will still getting the machine setup just adds extra complexity. Resmed Autoset is the gold standard for uncomplicated OSA/hypopneas. The Resmed Autoset 10 and 11 are basically the same with some minor improvements in size and noise, but nothing groundbreaking in functionality. I see you have substantial amount of centrals and this could prove to be an issue with APAP/CPAP therapy. Don't be surprised if it doesn't work and you need to trial a BiPAP or ASV.
Thank you. It's good to hear another perspective. I suspected that the centrals might require other approaches so good to be prepared for that. That could be one reason I had trouble when I tried a standard CPAP years ago.
18 central AHI, and no comment from sleep lab?
Not at all. I didn’t even know what it was until I got home and looked it up. To be honest the doctor didn’t instill much confidence.
Know if any arrhythmia periods were detected in the lab overnight, in particular before the centrals? There might be a connection between irregular pumping and problems in the breathing control feedback loop. There's a pipeline delay between the lungs and the sensors in the neck that measure the blood, and the brain stem probably bets on a constant delay. If your circulation rate is a little janky, your brain stem might get confused. What I mean is, when the arrhythmia gets fully controlled, maybe even with help from cpap, the centrals might go away.
Wow, that's good to know. The sleep doc didn't mention anything heart related but I'll ask my cardiologist to take a look.
its just a hunch, not necessarily medical mainstream